Comparative effects of combined aerobic and resistance training versus high-intensity interval training on insulin resistance, glycaemic control, body composition and quality of life in type 2 diabetes: A 12-week randomised controlled trial.

Both HIIT and A+R significantly reduced fasting glucose compared with control, with HIIT showing a greater reduction.

• HIIT group showed a greater reduction in fasting glucose (MD -29.1 mg/dL; 95% CI -41.2 to -17.0) versus control.
• A+R group also improved fasting glucose (MD -20.6 mg/dL; 95% CI -31.0 to -10.2) versus control.
• 90 participants with T2DM aged 30-65 years were randomised to A+R, HIIT, or control groups.
• Results were derived from covariate-adjusted mixed models with multiple comparison corrections (Benjamini-Hochberg FDR, q = 0.05; Bonferroni-adjusted α = 0.002).

HbA1c was similarly reduced in both HIIT and A+R groups compared with the control group.

• HIIT reduced HbA1c versus control (MD -3.35%; 95% CI -4.11 to -2.58).
• A+R reduced HbA1c versus control (MD -3.33%; 95% CI -4.03 to -2.62).
• Both exercise interventions were delivered 3-5 times weekly for 12 weeks.
• The control group received usual care without structured exercise.

Fasting insulin decreased in both exercise groups relative to control, with A+R showing a numerically larger reduction.

• HIIT reduced fasting insulin versus control (MD -7.16 mIU/L; 95% CI -10.04 to -4.28).
• A+R reduced fasting insulin versus control (MD -8.87 mIU/L; 95% CI -11.77 to -5.97).
• Both programs were 12-week interventions with 30 participants per group.

HOMA-IR improved significantly in the A+R group versus control, while the HIIT group showed only a non-significant trend.

• A+R improved HOMA-IR versus control (MD -2.33; 95% CI -3.63 to -1.03).
• HIIT showed a non-significant trend in HOMA-IR improvement versus control (MD -1.17; 95% CI -2.47 to 0.13).
• HOMA-IR was a primary outcome alongside fasting insulin and HbA1c.

Functional capacity measured by 6-minute walk distance increased in both exercise groups versus control, with A+R showing a greater improvement.

• HIIT increased 6-minute walk distance versus control (MD +178.9 m; 95% CI 130.5 to 227.4).
• A+R increased 6-minute walk distance versus control (MD +233.6 m; 95% CI 191.8 to 275.5).
• 6-minute walk distance was a secondary outcome measure.

Fat-free mass increased in both exercise groups compared with control, with HIIT showing a numerically greater gain.

• HIIT increased fat-free mass versus control (MD +7.54 kg; 95% CI 4.71 to 10.36).
• A+R increased fat-free mass versus control (MD +5.96 kg; 95% CI 3.06 to 8.86).
• Muscle mass was assessed as a secondary body composition outcome.

Both exercise interventions reduced subcutaneous fat and visceral fat compared with control, with A+R showing a slightly greater subcutaneous fat reduction.

• Subcutaneous fat was reduced by HIIT (MD -7.16%; 95% CI -9.33 to -4.99) and A+R (MD -8.37%; 95% CI -10.65 to -6.09) versus control.
• Visceral fat was reduced by HIIT (MD -4.70%; 95% CI -5.93 to -3.47) and A+R (MD -4.58%; 95% CI -5.86 to -3.31) versus control.
• Both subcutaneous and visceral fat were secondary body composition outcomes.

Quality of life improved across domains in both exercise groups versus control, with A+R showing a numerically greater improvement in the physical domain.

• Physical domain quality of life improved in HIIT (MD +10.29; 95% CI 4.06 to 16.51) and A+R (MD +13.77; 95% CI 6.62 to 20.91) versus control.
• Quality of life was measured using the WHOQOL-BREF instrument across multiple domains.
• Quality of life was a secondary patient-reported outcome.

The trial was a single-centre randomised controlled trial with findings limited to adherent participants without advanced diabetes complications.

• The study enrolled 90 participants with T2DM aged 30-65 years, allocated to three groups of 30.
• Findings are limited to adherent participants, and generalizability is restricted to those without advanced complications.
• The 12-week duration precludes assessment of long-term sustainability.
• The trial is registered with the Clinical Trial Registry of India (reference no: CTRI/2022/04/041762).
• A+R consisted of moderate-intensity aerobic and resistance exercises, while HIIT comprised structured interval sessions, both delivered 3-5 times weekly.